Male gender (HR = 1.88 95% CI, 1.44–2.46 P < 0001) was also associated with a higher risk of HCC development and the risk of HCC increased stepwise with increasing age.Įven though the HCC incidence during the follow-up seemed to gradually increase among nearly 3,000 patients with CHB, it did not significantly increase with increasing treatment duration. The optimal cutoff points for prediction of HCC were as follows: total bilirubin level of 0.82 mg/dL, serum albumin level of 4.0 g/dL, and platelet count of 131 × 10 3/μL ( Table 2). Next, these three variables were converted to binary variables using the Contal and O'Quigley method ( 19). Univariate analyses to identify factors associated with the risk of HCC development during follow-up showed that the total bilirubin and serum albumin levels and the platelet count were significantly predictive of HCC development. However, because the baseline characteristics of the patients differed among these studies ( 9–11), physicians should recognize them for an appropriate interpretation of the study results and further research is needed. ![]() ![]() In contrast, a prior study conducted in the Republic of Korea (ROK) showed that the incidence of HCC did not significantly change during and after the first 5 years of ETV therapy ( 11). Likewise, in a Taiwanese cohort, the risk of HCC decreased as the duration of AVT increased, even though older patients are more likely to develop HCC ( 10). First, among a cohort of European patients with CHB, in whom HBV genotype D infection acquired horizontally predominates ( 8), Papatheodoridis and colleagues ( 9) showed that the risk of HCC development tended to decrease after the first 5 years of AVT. Indeed, contradictory results have been reported. Although prolonged potent AVT improves necro-inflammation, fibrogenesis, and ultimately carcinogenesis in the liver, the pattern of temporal change in the risk of HCC over time during treatment of patients with CHB is still unclear. ![]() From the similar perspective, stratification of the cumulative probability of HCC occurrence among patients with chronic hepatitis B (CHB) undergoing NUCs has been an important issue.
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